抗上皮细胞抗体在单侧胸部照射引起的双侧放射性肺炎发病机制中的作用。
The role of anti-epithelial cell antibodies in the pathogenesis of bilateral radiation pneumonitis caused by unilateral thoracic irradiation.
作者信息
Fujita J, Bandoh S, Ohtsuki Y, Dobashi N, Hiroi M, Takeuchi T, Fukunaga Y, Miyaue H, Onishi S, Ishida T, Takahara J
机构信息
First Department of Internal Medicine, Kagawa Medical University, Japan.
出版信息
Respir Med. 2000 Sep;94(9):875-80. doi: 10.1053/rmed.2000.0858.
Two cases of bilateral radiation pneumonitis associated with unilateral thoracic irradiation against lung cancer are described. Both patients died of respiratory failure and autopsy was performed. Histologically, bilateral diffuse alveolar damage was demonstrated in both cases, associated with marked organization of hyaline membrane in one case (case 1). In addition, numerous hyperplastic type II pneumocytes which strongly expressed cytokeratins 8, 18 and 19 were observed. In both patients' sera, antibodies against cytokeratin 8, 18 and 19 were demonstrated by a Western immunoblot. The possible association between autoantibodies to cytokeratins and diffuse alveolar damage observed in patients with bilateral radiation pneumonitis are discussed.
本文描述了两例因单侧胸部照射治疗肺癌而引发双侧放射性肺炎的病例。两名患者均死于呼吸衰竭并进行了尸检。组织学检查显示，两例均有双侧弥漫性肺泡损伤，其中一例（病例1）伴有透明膜的显著机化。此外，还观察到大量强烈表达细胞角蛋白8、18和19的增生性II型肺泡上皮细胞。在两名患者的血清中，通过蛋白质免疫印迹法检测到了针对细胞角蛋白8、18和19的抗体。本文还讨论了双侧放射性肺炎患者中细胞角蛋白自身抗体与弥漫性肺泡损伤之间可能存在的关联。
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